HIV symptoms are caused by the effects of the human immunodeficiency virus (HIV) on the body. The main cause of these symptoms is the damage to the body’s immune system caused by the virus.
You will not develop any symptoms even after two weeks. It can take up to 4 weeks after the infection for the symptoms to appear – sometimes longer.
Opportunistic diseases, which take the opportunity of the weakened immunity during the last or the end stage of this infection, develop and cause the symptoms and signs, which are those of AIDS (Acquired Immune Deficiency Syndrome).
Are HIV symptoms common?
Among the people living with HIV, the early flu-like warning symptoms are quite common. They are seen in 80% of the people and are similar to those of flu or cold, giving no clue of the underlying dangerous infection. This is called ‘seroconversion illness.’
Symptoms vary from person to person. They may be persistent or occasional and mild or severe. They may stay or come and go.
All patients infected with HIV will seroconvert (go from negative to positive) at some time, but only those 80% of them will complain of some symptoms. Seroconversion usually occurs within 1 – 3 weeks after infection, but at times it could take up to 6 months.
According to The World Health Organization (WHO), HIV testing can be considered conclusive at 3 months or 12 weeks after your last high-risk exposure.
When do the HIV symptoms appear and how long do they last?
The symptoms do not come immediately, but appear almost two to four weeks after the exposure, which infects the person.
This is what makes this virus dangerous. The person, though infected does not know it due to the absence of symptoms during this period. He unknowingly passes the infection to others through the various modes of infection.
Once the symptoms have appeared, they last for about two to four weeks.
- Reading the clinical stages of HIV and AIDS and their accompanying symptoms will help you understand the progression of the disease and its symptoms.
HIV symptoms progression and timeline
As mentioned above, symptoms appear 2 to 4 weeks after you get infected with the virus. This is the first stage of the disease called the acute infection stage. Once they appear, they last for 2 to 4 weeks. Sometimes, the first stage of these symptoms can last for two months.
The second stage of clinical latency shows no symptoms and the person is well and hearty as far as the HIV symptoms are concerned. The second stage can last from 3 to 10 years.
The HIV infection then proceeds to last stage of progression to AIDS in about 10 years or so. The symptoms of AIDS are more serious and progress rapidly.
The last stage of the AIDS disease is the most critical and the person suffers the most. It is during this stage of progression to AIDS that the person if being untreated succumbs to the disease.
This stage of AIDS lasts only for 2 to 3 years during which the person dies. If the person is on antiretroviral treatment, this stage can be managed and controlled.
The person can then live a normal span of life, though he/she will always harbor the virus and be infectious throughout life.
HIV infection proceeds to AIDS in about 10 years or so. The symptoms of AIDS are more serious and progress rapidly. Untreated, AIDS almost certainly kills. To reduce the risk of mortality and morbidity, early treatment is of great help.
Therefore, if you have been exposed to HIV risk factors, such as unprotected sex, you must get yourself tested.
Unfortunately, the window period for the HIV infection to show positive in the 4th generation antigen/antibody test is four weeks. So, make sure you understand this and get yourself tested accordingly.
Proper treatment will give you a normal lifespan, though you will have the virus inside your body throughout life and you will always stay infectious.
Early symptoms common to men and women
The early symptoms and signs can be defined as those appearing in the first stage of HIV, namely the acute infection stage.
As the virus is actively multiplying inside the blood stream, there is an inflammatory response to this activity by the immune system. This is what causes the early symptoms of skin rash, fever, swollen glands and weakness.
Though the person is infectious all through his life, he is most infectious during this early stage.
This is because of the rapid multiplication of the virus during the early weeks of the infection and release of these new virus particles into the blood.
The symptoms can be mild or severe. The intensity or the severity of the symptoms depends on the viral load. The higher the load, more severe are the symptoms.
Some people may not experience any symptoms at all for years. They may feel them after AIDS has developed and the opportunistic infection has produced its symptoms.
The most common body-wide symptoms that first develop and which are common to men and women are explained below. Further down, the symptoms that are exclusive to women are described.
Fever with a body temperature above 100.4ºF or 38ºC. Adults and children with temperatures higher than 102 degrees and not responding to antipyretic medication should see their healthcare provider to rule out the cause of the ever.
Skin rash on the body
The skin rash mostly affects the upper half of the body and you will see it on the shoulder, chest area, face, torso and palms of your hands. It is flat in appearance, reddish on the light colored skin and dark on the dark-colored skin. It does not cause itching and disappears in about 3 weeks.
Headache of HIV is unrelenting. It can be mild or severe. It is often caused by low CD4 T-cell counts but may also be due to infection.
Muscle and joint pain
HIV can cause peripheral neuropathy, which results in numbness, tingling, or burning in the fingers and toes. This is due to nerve damage caused either by HIV or due to the HIV medicines.
Myalgia presents as muscle ache causing body pain all over.
Joint pains or joint aches, called arthralgias, occur in 45 percent of all people living with HIV and affect only the large joints. They become hot and swollen and respond to non-inflammatory analgesics. Even the Achilles tendon and the plantar fascia in the arch of the foot can get inflamed.
In addition, other less common symptoms can appear, which include
Sore throat and dry cough
Dry cough that persists for days or weeks in spite of treatment with antibiotics and cough syrups is indicative of the HIV cough.
Diarrhea can be an early sign in an HIV patient. It can range in severity from occasional loose motions to being chronic.
It can arise due to the overlapping infections due to bacteria, fungi, viruses and parasites. It can also arise as a side effect of the HIV medicines.
Weakness and fatigue
The symptoms of fatigue and weakness are common among the patients living with HIV.
Due to the active virus inside the body and the body’s ongoing losing battle of the immune system, a lot of energy is constantly being used. This can make the person feel tired. The higher the viral load more is the weakness.
Secondly, a patient of HIV is under immense mental strain due to the nature of the illness. Such a mental setup can increase the fatigue and weakness.
Loss of appetite
There are several reasons why a HIV positive person loses his appetite and does not eat well.
One cause could be the virus itself, which alters the sense of taste in the mouth. Other reasons can be a sense of depression, side effect of medicines taken for treatment, and oral infections or other overlapping infections.
Loss of weight without any apparent cause
One reason for the loss of weight is the loss of appetite due to which the person does not eat well.
The other reasons can be the HIV virus itself, the HIV drugs, which kill your appetite, make the food taste bad, or make it difficult for your body to absorb the nutrients.
Swollen lymph glands
Normal healthy lymph glands are not noticeable and cannot be palpated. In HIV infection, lymph glands become swollen (adenopathy) early on a few days after the infection. They are not painful.
Those that swell early on are those in the armpits, neck and the groin.
As the infection progresses, more lymph glands get involved. This is due to the HIV infection.
Adenopathy occurs in about 75% of the people who have primary HIV infection.
Lymph nodes belong to the lymphatic system, which is an important part of the body’s immune system.
Swollen lymph nodes mean that they have been infected and that the body is trying to fight the infection. These swollen nodes subside with time while in some they may stay swollen for years.
Symptoms specific to women
Besides the above signs and symptoms, infected women may face some additional changes.
Changes in the menstrual cycle
Women with HIV may experience lighter or heavier than normal periods. Or, they may not have a period at all.
The intensity of the premenstrual symptoms may be more severe. Such symptoms include anxiety, depression, insomnia, acne, fatigue, and headaches.
Pelvic inflammatory disease (PID)
Pelvic inflammatory disease is infection of the uterus, fallopian tubes, and ovaries. In HIV positive women, PID is harder to treat and its symptoms are more severe in nature. Symptoms include
- pain in the upper or lower abdomen
- painful sex
- pain while passing urine
- irregular menstrual bleeding
The no symptoms stage or the stage of clinical latency
Approximately two months after the HIV infection first sets in, a “miracle” starts happening.
All symptoms disappear and the person starts feeling well for long periods, which can extend to almost three to ten years. There is nothing at this stage to suspect that the person is ill.
The virus is there very much within the body’s immune cells, but is lying dormant or latent. The body and the virus are living in harmony with each other.
You can say that this is the silence before the big storm. If the person is on antiretroviral therapy, he can live for decades in this fashion and not progress to the next stage of AIDS. However, he or she still stays infectious.
An unsuspecting patient on no treatment starts developing the last and terminal stage of the disease called AIDS after anywhere between 3 to 10 years long years of this second stage.
Once AIDS develops, life expectancy is only 2 to 3 years.
Anti retroviral therapy (ART) will slow down the progression of AIDS for many years.
AIDS is a syndrome of opportunistic infections, whose symptoms start setting in rapidly due to the compromised immunity of the person.
Progressive common symptoms of AIDS include:
- Recurring fever more than 100 degrees F (38 C) lasting for more than a few weeks
- Night sweats
- Cough with shortness of breath
- Chronic diarrhea that can last for more than a week
- Rapid loss of weight
- Extreme and unexplained fatigue
- Long standing swelling of lymph glands in the neck, armpits or the groin
- Sores develop in the mouth, the genital and/or the anus.
- Lung infection commonly pneumonia
- Round, brown, reddish or purple spots that develop in the skin or in the mouth caused by Kaposi sarcoma
- Loss of memory
There are 26 opportunistic diseases that can develop in a person with AIDS and which can be caused by bacteria, viruses, fungi, and parasites. The symptoms that appear correspond to the disease that has set in.
The most common initial diseases that can alert the physician about the onset of AIDS are:
- Tuberculosis (TB). In poor developing nations, TB is the most common opportunistic infection associated with HIV and a leading cause of death among people who have developed AIDS.
- Pneumocystis pneumonia, which is seen in 40% of these patients
- Cachexia or wasting syndrome in which there is muscle atrophy, loss of appetite, loss of weight, fatigue, and weakness. These conditions cannot be reversed by extra nutrition. This is seen in about 20% of such patients.
- Candidiasis infection of the esophagus. Candidiasis is a yeast infection caused by Candida albicans. In people with HIV, candidiasis commonly affects the skin and mucous membranes such as the mouth, throat, esophagus and vagina.
Do all untreated HIV patients progress to AIDS?
There is a very small percentage of people who get infected with HIV but do not progress to AIDS. These are called nonprogressors and they seem to have a genetic ability, which prevents the virus from damaging their immune system.